practice makes perfect

Jumped the Gun

When I posted the piece on Merriam Webster's annual "top ten" list early this month, I had no idea that one word could easily dwarf all others for the year in the last wee days of 2004.  So sad it had to be a word of utter destruction and heartbreak, yet as one commentator remarked, 'it reminds us all how little we control in this world, and puts us in awe of creation'.  The word is tsunami.

BLOG = Word of the Year 2004

Merriam Webster calculates the 10 most popular dictionary look-ups each year, and for 2004, blog tops the list!

The others, in descending order, are:   

2. incumbent
3. electoral
4. insurgent
5. hurricane
6. cicada            
7. peloton : noun (1951) : the main body of riders in a bicycle race
8. partisan
9. sovereignty
10. defenestration

Funny – just like looking up the top searches in Google, we can relive the year in words, in a particularly more succinct way than the hour-long extravaganza video blitz the networks air each January.

Rather short and to the point, except – did I miss a story about the act of defenestration being performed on someone?  Actually, it could be a person or a thing, so you can fill in your own blank about the reason for the word occupying the number 10 spot. Any comments?

You can go directly to the list here.

Morality and Medical Skills

Weekend Edition on NPR aired an interesting piece this morning on the correlation between medical students' development of medical skills vs. development of moral conviction. They cited two rather disturbing studies which concluded that the further a student progresses in medical school, the harder it becomes to continue developing their moral and ethical standards in caring for patients.

The primary deterrent to this development rests on the "system" which places interns and their decisions under the direct control of the people responsible for their evaluations, and consequently, their successful career launch. Interviews with these young doctors revealed feelings of mental conflict when they were placed in positions where they were told how to handle patients and their close relatives in morally or ethically sensitive situations. In many cases, they felt coerced to ignore their gut feelings in order to appease the doctor in charge. Interestingly, students' loss of guilt or conflict in these situations increased the further they progressed in their training - in direct opposition to the gain in medical skills during training.

Therefore, the study hypothesizes, when doctors finally enter real positions of authority, they have traveled backward, instead of forward, in what is considered the "normal" evolution of a persons' moral and ethical sensitivity. Hear the NPR piece with study references here.

Not being a doctor, I cannot say this is true, but I can relate it to the larger world, where the ramifications tend to be subtler. As well as being depicted as an issue in medicine on such shows as E.R., this denial of self autonomy manifests itself in all of academia (particularly the sciences), as well as existing in healthy doses in the corporate world.

My husband is a scientist who holds views that are unpopular (but cannot be disproved) in the academic scientific community. Anyone who disagrees with unproven, yet widely accepted hypotheses is ridiculed and ignored, without any objective review of their work. Students are coerced into espousing the beliefs of the professors who control whether or not they will receive their graduate degree. Anyone who thinks objectively or independently is discouraged from considering other viewpoints. Most significantly, the peer review process is the final blow against independent thought. I'm sure here, too, there’s a direct correlation between the volume of information absorbed and the increasing acceptance of how to work the "system" by maintaining the status quo.

One of the reasons I'm here now, writing this blog, maintaining physician-central, and working on other research projects is because I don't feel I can ever go back to the corporate hierarchy that regularly made me question whether I would be expected to do something I didn't personally feel comfortable with. In some cases, it seemed the less ethical a person was, the higher they rose, and the more authority they gained over more people. Political alliances and the party line seemed more important than the product or service we were ostensibly entrusted with providing.

The point is, this is a phenomenon that is inherent in all institutions. Doctors and hospitals are not immune, it just seems more sensational when you apply it to the ultimate moral dilemmas surrounding life and death.

I have been remiss....

The telltale date on my last post shows how long I have been immersed in multiple work projects and a number of family dramas. Tonight I have launched the search by state function on physician-central, so now I can devote more time to practice makes perfect.

The directions to take these posts are many, but I would really like to pursue getting some expertise on Practice Economics and financing, and also spotlighting some interesting areas of the country and its cities.

I would also like to feature some books and guest authors, so I will be sending out some invitations soon. Check back soon, and I promise to have some more material here!

Other or New Category Please!

Well, I came up with the list of categories you see to the left, trying to think through the different topic areas that might be of interest to physicians just starting out, or those contemplating a move. Categories without a post yet are:
Practice Economics
Flying Solo
Practice Politics
Relocatiing Family
Making the Decision to Make A Change
Suburbia
Quality of Life
Other/New Category Please is the catch-all, miscellaneous, and all the categories I never thought of choice.
I'll be including some bits of research in all these areas, so please send me a comment on your interests.
Thanks.